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General NPI Number Information
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NPI Number | 1124756846
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Entity Type | Organization
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Legal Business Name | TANGLED WELLNESS LLC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 1775 SAINT JAMES PL STE 325
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City | HOUSTON
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State | TX
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Zip | 77056-3416
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Country | US
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Telephone | 832-266-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 1775 SAINT JAMES PL STE 325
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City | HOUSTON
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State | TX
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Zip | 77056-3416
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Country | US
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Telephone | 832-266-7007
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DUSTIN ZEIGENBEIN
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Credential |
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Telephone | 281-908-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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